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14703 POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER CITY OF CUPERTINO INSPECTION DIVISION � � li JOB INSPECTION RECORD 1' PERMIT EXPI9ATION , . JOB ADDRESS_p-7�/ -•vV�+'<�✓ �/ UNIT# _LOT# PERMIT EXPIRES IF WORK OWNER CONTE ACTOR0 IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECOR - teo onus OF PERMIT Issu- FOUNDATION . - ANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION: LIFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED r PREGUNITE TO COMPLY WITH THE APPROVED PLANS AND CITY.OF PERMIT VALIDATION CUPERTINO STANDARDS. GARAGE SLABS _ - POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED j^31-$$ - '•� r -� UNDERGROUND /SLAB - O k _ LpL C " �TXIG • PLUMBING ELECTRICAL ' ISSUANCE DATE MECHANICAL .jOP•. bLOG ELECT PLG. MECH. �f C�Pe ] ❑ ❑ D DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED y,',• - BUILDING PERMIT INFORMATION WOOD FLOOR PLUMBING VALUATION SrFT. � - �.: MECHANICAL - ELECTRICAL PENAllT TO - FRAMING' INS LATIONSTORIES TYPE CONSTR. - OCC,GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED ' ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE sn.FT.FLoaN area TOTAL ACR EACL DIAPHRAGM THE CONSTRUCTION TAX IS PAID _}. BUILDING USE ROOF SHEATHING RES INTI CON Pe oln., APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED • FINALS DATE INSP. ❑ '❑ ❑ ❑ ❑ ASSESSORS PARCEL NO, ROUGH SAN.# PLUMBING - ELECT. ENERGY ' TRACT NO. PARC[L NO. TUBS&SHOWER PAN �� PLUMBING ENERGY ' MECHANICAL MECH.ENERGY ELECTRICAL �,Qq�' BUILDING ENERGY . ACC.DATE ACC.FILE NO, FRAMING ELECT.FINAL TEST ZONING ENG.SITE NO. ' INSULATION PLUMBING GAS TEST - GAS ' FIRE SPHINK ENERGY T-24MECHANICAL COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING' - Y F] NL]- .� ° o' NE] 'h! EXTERIOR SHEAR ELECTRICAL RELEASE - FLOOD/ONE AL U.C. ' INTERIOR SHEAR FIRE DEPT. ❑ N❑ Y L_ N❑. SHEETROCK - . GRADE. FEESUMMARY EXTERIOR LATH BUILDING' INTERIOR LATH97 TEMPORARY APPROVALS - • A3ILDING SCRATCH COAT ELECTRIC PCAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY. - SEISMIC FEE T�,:' OCCUPANCYOF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC >/ Lu ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING � Z PLEASE GIVE JOB ADDRESS WHEN PHONING. — SEE PERMIT FOR EXPIRATION.DATE — MECHANICAL IMPORTANT! CONST.TAx . PLEASE'READ REVERSE SIDE BEFORE CALLING FOR .FINAL INSPECTION: TOTAL OFFICE COPY, APPLICANT TO FILL IN INFORMATION WITHIN RED LINES.- USE BALL POINT PEN ONLY e r ~ BUILDING PROJECT IDENTIFICATION - PERMIT NUMBER BUILDIRc - APPLICATION & PERMIT r� O^ ADDRESS r .,• I 3 /�L�• -'ELECTRICAL- OWNER'S PLAN CHECK VALIDATION i° "AME ��� -3 OTY ELECTRIC PERMIT a FEE - ONE CONTRACTORS NAME r� OUT LETS-SWITCHES -RECEP 10.00/1.00 � - in NoLIGHTING FIXTURES 10.00/1.00 syC CON ADDHECS. PPLIANCES-RESIDENTIAL 4.00 10 NONE J/ -03 - PANELS 10.00 DATE OF APPLICATION OR ARCHITECT PANELS (OVER 200 AMP) - 20.00 PLAN CHECK FEE P.C.NO. ENGINEER LIC.NO. SIGNS TRANS. 3.00 ARCH. OR ENG SPECIAL CIRCUIT 5.00 PERMIT VALIDATION 0 ZIP TEMP. METERORPOLE.INS. 20.00 - - APPLICANT'S q ADDRESS MOTORS SEE FEE SCH. SERVICE CHANGE 20.00 31 �W�/�-/`-J e ¢ i P1iw F o O LICENSIi1)CONTRACTORS DECLARATION au� 1 hereby affirm Ihm I am licensed under provisions of.Chapter 9 1 - z w ARD a ISSUANCE DATE G a a (emmmicoisC With Section ]000)of Di 11f 3,of the Business and _ nB0D0. ,.ECECTJ /sPLG. MECH. H w i License io las I my license is in(u 11 for and uL(• L s' 1gQC� - oi y Wk License Class �Lic.Number / 7 H m H J Date!-_f1�_L2�Contmc90 , � - ��__f^❑ - IRO ""J.'BUIL'DING PERMIT ¢ ¢ w a OWNER-tlUIhDHR DECLARATION - .. . wt,CnOBff U INFORMATION X ; y I hereby affirm that I am exempt from the Contractor's License MISC.- � b1L7 `REFER TO ORD a_o j Law for the following reason.(Sec.7031.5,Business and Professions a VALUATION S/FT. - PERMIT ISSUANCE 10.00 Code:Any City or county which mquims a permit to construct,alter. ¢ improve,demolish,or repair any structure,prior In its issuance,also ELEC.CONTR. LIC.NO. ELEC. , / `l O ¢ requires the applicant for st Lh pumtil to file a signed statement Ihal TOTAL w he¢ PERMITO licensed pursuant to the provisions of the Contractor's License ' R z i Uw(Chapter 9(commencing with Section 7000)of Division 3 of the �/IfTG37Z�l�x�, E�O 'L 3 ¢ o Business and Professions Codd or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE re r the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. n i by any'applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500).): ALTER-DRAIN&VENT-WATER (EA.) 5.00 ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECTDEVICE 400 their sole compensation,will do Thee Work,and the structure is not . . OCC.GROUP -RES.UNITS intended or offered for sale Bac. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who does such work FIXTURES-PER TRAP - 5.00 SG FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees.provided that such impro v- mentsarenolintendedorofferedfor sale.If,however,the building GAS-EA.SYSTEM:11NC.4 OUTLETS 6.00 or improvement Is sold within ane year of completion,the owner- GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 builder will have the burden of proving that he did not build or im- BUILDING USE prove for purpose of sale.). RESINDUSTRIAL WASTE INTER. 30.00 ❑ I❑ ❑N ❑ pO_ ❑ L c owner of the property,he exclusively S, contracting with licensed camas Cod m construct the pricense La 7044,or applss LAWN SPRINKLERS- 1 INC 6 V.B. 6.00 ASSESSORS PAR CEL NG. and nProfessions grope The Contractor's License Law dues nn apply to t,owner of property who builds or improves need p.and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 the Cont for is projects with a conrracrorts)licensed pursuant ro - rnc 1dF1 exempt License Law. SEWER-SANITARY-STORM EA.200ft/10.00 TRACT No. . PARCEL NO. reason WATER um exempt mnder See,-,B.&P.C.for this WATER HEATERaW/VENT• 6.00 Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORK ERS'COMPBNSATION DECLARATION WATER TREATING EQUIP. 5.00 ' I hereby affirm Ihut I have a certificate of consent to self-insure. or a cee'liificate of Work�err,Compensation Insurance,or a certified ZONING ENG.SITE.NO. XIcy(k(o�-I �3 Rylr. ❑ Certified py ls( reby Punished. ' FIRE SPRINK ENERGY T]4 Z = ❑ Cerlil opy is -c wi the city pection division. O ADPIica MISC.- REFER TO ORD. Y❑ N v ❑ NEI cc: 0 CERTIPICATIi OP I X17,MPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. W > COMPENSATION INSURANCE PLG.CONTR. LIC.N0. PLG. CL O (This Section need not be completed if the permit is for one. TOTAL Y❑ No , Y 0 N 2 hundred dollars IS 100)or Is.) U O 1 certify that in the tsed.nmwme of the work for which thisparr- O.ry MECHANICAL PERMIT FEE FEE SUMMARY LL H Fair is issued,I hall not employ my person in any manner so as m ❑ become subject to the Workers'Compensation Laws of California. U a DateApplicant - ALTER OR ADD TO MECH. 5.00 BUILDING Q .�� } w NOTICE 10 APPLICANT: If,after making this Certificate of Ex- �.. ? emptioa,you should became subject m the Workeri Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE U such provisions or this permit shall be deemed revoked AIR_HANDLING UNIT ITO 10=C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10,0MC.F.M.) 6.00 -1 SEISMIC FEE e9'� I hereby affirm that there is a construction lendinC agency for EXHAUST HOOD(WITH DUCT) 5100 ,�f. the performance of the work for which this permit is iswd(See. Os MICROFILM 3097.Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.0_0 vj Lender's Name -. ��LECTRIC Leader's Address HEATING UNIT(OVER 100,000 B.T,Usl B:50 1 certify that 1 have read this application and state Ihaf the above VENTILATION FAN (SINGLE) s. 4.00 s .,1.w1\ information is rorLet. I agree to comply with all cdy and county ordinances and slate laws relating to building construction, and BOILER-trf(3H.P.or 100,000 B.T.U.)(6A0�' PLUMBING hereby mitIm,mentioned ropertyforiins of This city In enter upon the - BOILER-0OMP lover 100,000 BTU)SEE FEE SCH. / 40 abovrmemiurleJ property for inspection purposes. MECHANICAL (we) agree to save, indemnify and keep harmless the City'of MISC.- REFER TO ORD. uNdino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 1000 CONST.TAX e1Wdi5jebf sy way accrue against said City in consequence of the Q this permit. MECH,CONT. LIC.NO. OMECTOTAL LCTOTAL o(Applicant/Cnnlmd Or Umc / OFFICE COPY